Within the context of health care, and emphasizing the importance of communications, what kind of organizational structure is most likely to prove effective, particularly in terms of employee...

Within the context of health care, and emphasizing the importance of communications, what kind of organizational structure is most likely to prove effective, particularly in terms of employee participation in decision-making?

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kipling2448 | (Level 3) Educator Emeritus

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Only the student submitting this question can describe the organizational model or structure of which he or she is a part. What follows, however, is an attempt at addressing the question in a generic manner applicable to many situations.

While the stakes can be considerably higher in the case of health care organizations, the fundamental concepts of organizational structure need not differ dramatically from that employed in business, sports, or other types of organizations.  A failure to establish a logical structure, complete with clearly articulated missions, divisions of labor, and hierarchy (or chain of command) will invariably lead to less efficient operation than would otherwise be the case.  Within the health care industry, organizational structure tends to be somewhat formulaic, but the requirement for effective communications and for positive employee participation in decision-making can be much more important than in other industries.

Patient care can literally be a matter of life-and-death decision-making and efficient execution.  The administrative component of health care enjoys little room for error, as miscommunications or improper record keeping can result in malpractice involving seriously jeopardized patient care and the potential for lawsuits and reputational damage. The act of administering medical care to the sick carries enormous responsibilities, and a premium has to be placed on team work, which includes communications up and down chains of command and across specialties or departments.  The pressures associated with the provision of medical treatment for serious conditions means the potential for miscommunications is high, and incompatible personalities can harm patient care.

In many organizations, leadership skills can determine success or failure.  In health care, they are absolutely essential. Good leaders understand that employee participation and morale are important for organizational and personal success.  In an industry in which egos and temperaments tend towards the outsized, however, and in which split-second decisions can be the difference between life and death, the premium placed on leadership abilities is particularly high.  Patient confidence, for one, is lost if the patient perceives that he or she is submerged within a dysfunctional operating environment.  To the extent that the tone is established at the top of the organizational pyramid, there can literally be no substitute for adequate leadership abilities that permeate throughout the building.

Opportunities for information sharing invariably occur during staff meetings or in impromptu one-on-one sessions between colleagues or between managers and subordinates.  Again, the distinction between management and leadership is determined in no small part by how receptive the managers are to input from below.  Good managers are good leaders, and understand the importance of soliciting and appearing receptive to recommendations from below.  Good managers also recognize the value in establishing teams or committees tasked with studying and developing recommendations for how to improve organizational efficiency.  Group dynamics can reveal underlying problems that otherwise festered unrecognized and went unaddressed, yet which adversely impacted organizational efficiency.  The use of exercises, for example, role playing and crisis-response simulations can help identify weaknesses while providing employees an enhanced sense of empowerment.

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